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When death is near, should children be there for the actual event?

The answer to this question depends on the age of the child, and the other parent or the child’s caregiver will need to continue to give the child information and prepare them for what will happen next. Given the fact that cancer is often an illness that can last many months or years, children will have been around for much of their parent’s experience. Hopefully, the child will have been kept well informed all along and will understand that their mom or dad is nearing death.

When a parent becomes sicker, there’s a natural tendency to protect the child from the signs of advanced disease. Parents don’t want their child to see them vomiting, in pain, or not able to eat. They don’t want the kids to realize that mom or dad is too sick to pay much attention to them. But it’s impossible to protect them from everything, least of all from the fact that their parent is more tired, has less patience with them, looks sicker, and is less able to get around. This is also a good time to find out if the cancer center has a support group for kids whose parent has a terminal illness or who have lost a parent to cancer.

Shielding children from these realities may slow down their adjustment to the situation. So use these symptoms as a way to help children understand that the parent is getting closer to the end of life.

Young children do not need to be there when a parent actually dies, but it’s important for them to stay in their home where they feel the most secure. It may be tempting to have a child stay with another relative during this time, but that can create other problems for the child. Children who have had this experience often resent it. Some of those children said, after they were older, that it made them feel excluded from their family. They felt that their relationship with their parent was not considered important. Some said that it seemed like the family assumed that they could not cope with such a scary and terrible thing as death, so they were sent away.

If a parent is in the hospital, children should be allowed as much contact with the parent as possible. The same applies to a parent who is dying at home. Keep in mind that younger children may need coaching and planned activities to enjoy their visits more. Studies have found that children recalled feeling anxious, uncertain, or disappointed when they spent time with a sick parent. The child often found these memories painful after the parent’s death. It’s important that the child be prepared for what to expect on these visits. They should have things to do and not be expected to sit quietly at the bedside. Most parents enjoy having their kids talk to them about their friends or school. They also enjoy watching or hearing their kids play and have fun, even when they can’t take part themselves.

Children should also be encouraged to keep taking part in whatever activities they enjoy normally. Children and teens cannot and should not be expected to keep a vigil at their parent’s bedside, as noted above.

Young children (under the age of 6 or 7) enjoy a physical relationship with their parent. They like being cuddled, played with, and being cared for to whatever extent their sick parent can do these things. It’s important to continue this as long as possible, for the sake of the parent and the child.

If the child is older than 7, adults should follow the child’s cues about how much time they want to spend with a dying parent. If a parent is at home, give a child regular activities that they can take part in with their sick parent, such as playing a favorite game that the parent can easily manage (such as a board game), or helping with homework if possible. Some children enjoy reading to their parent or cuddling and watching TV together. These brief periods of time will be sweet memories for the child in the future. Those feelings of closeness will be important when the parent is no longer physically there to comfort the child.

Teens may want to help with some of the sick parent’s care. Their comfort level in doing so will depend on their relationship with the parent, school demands, and their social needs. Since teens are in a phase of their lives when they are naturally separating from their parents, finding the right balance between time spent with a sick parent and time spent on other aspects of their lives can seem challenging.

Teens can do household chores, and it’s natural to depend on them to pitch in during a crisis. In fact, teenagers get satisfaction from being trusted enough to help out when the family is in upheaval. It’s important to ensure the teen is still able to have time with friends, take part in school activities, and have parts of their lives separate from the family. It’s good to check in every now and then to see if the balance between home and the rest of their lives is being maintained.

Older children and teens might want to be there when a parent is dying. If the parent is OK with that, this should be supported. Some conflicting feelings are normal since there’s fear and uncertainty involved. It might be useful to ask someone from the medical team to describe what’s most likely going to happen. (You can also find detailed information in Nearing the End of Life. You can read it on our website or call us to have a copy sent to you.) If a child wants to be with his or her dying parent, they should not be alone. The other parent or a close family member should be there, too. If children do not want to be involved in the death of their parent, that wish should also be respected.

After death occurs

It’s often helpful for the surviving parent (or the child’s caregiver) to let the child/teen see the body before it’s taken away. This gives them a chance to say goodbye and helps to make the death a reality. Some children/teens may want to write a letter or select a special item to send off with the parent.

At the time of death the child/teen may cry, scream, or laugh – any of a range of emotions is possible. Or, they might want to avoid showing any strong emotions, but express their feelings in other ways such as by hitting, yelling, or wanting to be left alone. The child/teen needs to know that there’s no right or wrong way to grieve, and they can deal with it in their own way. Adult support and supervision is key. There will be a lot of changes, and kids of all ages need to know there are adults there who are watching out for them and taking care of them during this time. It helps to keep a regular routine with friends, activities, and school.

Younger children

After death, a younger child may feel upset that the parent doesn’t come home day after day. They may ask the same questions over and over, like, “Where did he go?” Offer the child things that seem important from the parent who died, such as special belongings or gifts they may have left for the child. Some children find it comforting to have clothing or other items that had belonged to the parent, especially during the first year or so after the death.

Be prepared for trouble sleeping, and younger children may be clingy and not want to sleep alone. This usually gets better over the course of a few months. If available, it may help the child to go to bereavement groups with other children.

Most children like looking at pictures of their parent during happier times, and hearing stories about them. Routines are important, so try and get back to them quickly. Help the child get back to school and their usual activities at least by the time all the ceremonies are over.

Teens

After a parent dies, some teens cry or get very angry, while others want to spend time alone. Some need to be around friends and talk. Teens also find it comforting to have pictures, clothing, and/or other items that had belonged to the parent.

Teens may regret arguments with the parent, disobedience, and other issues. There may be guilt over things the teen said or didn’t say to the parent. Sometimes it helps for the teen to write a letter to the parent saying all the things they didn’t say before, as well as all the things they wish they could say now. For many teens, it helps to talk to an adult who can listen without judging them. There are also support groups and web sites that are just for teens – these can be safe outlets for feelings and good sources of support and encouragement.

Because of the turbulent nature of this stage of growth, a parent’s death during the teen years can result in more trouble achieving an identity separate from the parent. This doesn’t mean the child is forever damaged, but it will be important for them to have relationships with other adults so they can continue to develop a sense of self.